Minimal use of ICD social determinant or phenomenological codes in mental health care records

Figures & data

Table 1. Primary diagnoses: “organic, including symptomatic, mental disorders”.

No code		n 17,045	% 78.5
“Organic, including symptomatic, mental disorders”
F00.0	Dementia in Alzheimer's disease with early onset	7	0
F00.1	Dementia in Alzheimer's disease with late onset	45	0.2
F00.2	Dementia in Alzheimer's disease, atypical or mixed type	13	0.1
F00.9	Dementia in Alzheimer's disease, unspecified	4	0
F01.2	Subcortical vascular dementia	1	0
F01.3	Mixed cortical and subcortical vascular dementia	11	0.1
F01.8	Other vascular dementia	2	0
F01.9	Vascular dementia, unspecified	138	0.6
F02.0	Dementia in Pick's disease	9	0
F02.2	Dementia in Huntington's disease	2	0
F02.3	Dementia in Parkinson's disease	20	0.1
F02.8	Dementia in other specified diseases classified elsewhere	5	0
F03	Unspecified dementia	120	0.6
F05.0	Delirium not superimposed on dementia, so described	7	0
F05.9	Delirium, unspecified	3	0
F06.2	Organic delusional [schizophrenia-like] disorder	4	0
F06.3	Organic mood [affective] disorders	2	0
F06.7	Mild cognitive disorder	355	1.6
F06.8	Other specified mental disorders due to brain damage and dysfunction and to physical disease	3	0
F06.9	Unspecified mental disorder due to brain damage and dysfunction and to physical disease	1	0
F07.0	Organic personality disorder	13	0.1
F07.1	Postencephalitic syndrome	1	0
F07.2	Postconcussional syndrome	2	0
F07.9	Unspecified organic personality and behavioural disorder due to brain disease, damage and dysfunction	1	0
G10	Huntington's disease	4	0
G20	Parkinson's disease	5	0
G30.0	Alzheimer's disease with early onset	18	0.1
G30.1	Alzheimer's disease with late onset	341	1.6
G30.8	Other Alzheimer's disease	235	1.1
G30.9	Alzheimer's disease, unspecified	146	0.7
G31.0	Circumscribed brain atrophy	7	0
G31.8	Other specified degenerative disorders of nervous system in diseases classified elsewhere	25	0.1

Table 2. Primary diagnoses: “mental and behavioural disorders due to psychoactive substance use”.

“Mental and behavioural disorders due to psychoactive substance use”
		n	%
F10.0	Mental and behavioural disorders due to use of alcohol: Acute intoxication	1	0
F10.1	Mental and behavioural disorders due to use of alcohol: Harmful use	11	0.1
F10.2	Mental and behavioural disorders due to use of alcohol: Dependence syndrome	524	2.4
F10.5	Mental and behavioural disorders due to use of alcohol: Psychotic disorder	3	0
F10.6	Mental and behavioural disorders due to use of alcohol: Amnesic syndrome	6	0
F10.7	Mental and behavioural disorders due to use of alcohol: Residual and late-onset psychotic disorder	7	0
F11.2	Opioid dependence	151	0.7
F12.1	Mental and behavioural disorders due to use of cannabinoids: Harmful use	3	0
F12.2	Mental and behavioural disorders due to use of cannabinoids: Dependence syndrome	2	0
F12.5	Mental and behavioural disorders due to use of cannabinoids: Psychotic disorder	1	0
F13.2	Mental and behavioural disorders due to use of sedatives or hypnotics: Dependence syndrome	2	0
F14.1	Mental and behavioural disorders due to use of cocaine: Harmful use	3	0
F14.2	Mental and behavioural disorders due to use of cocaine: Dependence syndrome	5	0
F14.5	Mental and behavioural disorders due to use of cocaine: Psychotic disorder	1	0
F19.1	Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances: Harmful use	12	0.1
F19.2	Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances: Dependence syndrome	23	0.1
F19.5	Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances: Psychotic disorder	9	0

Table 3. Primary diagnoses: “mental, behavioural and neurodevelopmental disorders”.

“Mental, behavioural and neurodevelopmental disorders”
		n	%
F20.0	Paranoid schizophrenia	221	1
F20.1	Hebephrenic schizophrenia	3	0
F20.5	Residual schizophrenia	14	0.1
F20.6	Simple schizophrenia	2	0
F20.8	Other schizophrenia	8	0
F20.9	Schizophrenia, unspecified	260	1.2
F21	Schizotypal disorder	1	0
F22.0	Delusional disorder	44	0.2
F23.3	Other acute predominantly delusional psychotic disorders	1	0
F23.9	Acute and transient psychotic disorder, unspecified	32	0.1
F25.0	Schizoaffective disorder, manic type	4	0
F25.9	Schizoaffective disorder, unspecified	93	0.4
F28	Other nonorganic psychotic disorders	1	0
F29	Unspecified nonorganic psychosis	61	0.3
F30.0	Hypomania	1	0
F30.1	Mania without psychotic symptoms	1	0
F30.9	Manic episode, unspecified	2	0
F31.0	Bipolar affective disorder, current episode hypomanic	8	0
F31.1	Bipolar affective disorder, current episode manic without psychotic symptoms	18	0.1
F31.2	Bipolar affective disorder, current episode manic with psychotic symptoms	5	0
F31.3	Bipolar affective disorder, current episode mild or moderate depression	2	0
F31.5	Bipolar affective disorder, current episode severe depression with psychotic symptoms	2	0
F31.6	Bipolar affective disorder, current episode mixed	1	0
F31.7	Bipolar affective disorder, currently in remission	1	0
F31.8	Other bipolar affective disorders	7	0
F31.9	Bipolar affective disorder, unspecified	207	1
F32.1	Moderate depressive episode	57	0.3
F20.0	Paranoid schizophrenia	221	1
F32.2	Severe depressive episode without psychotic symptoms	21	0.1
F32.3	Severe depressive episode with psychotic symptoms	38	0.2
F32.9	Depressive episode, unspecified	249	1.1
F33.1	Recurrent depressive disorder, current episode moderate	12	0.1
F33.2	Recurrent depressive disorder, current episode severe without psychotic symptoms	10	0
F33.3	Recurrent depressive disorder, current episode severe with psychotic symptoms	17	0.1
F33.4	Recurrent depressive disorder, currently in remission	2	0
F33.8	Other recurrent depressive disorders	1	0
F33.9	Recurrent depressive disorder, unspecified	275	1.3
F34.0	Cyclothymia	4	0
F34.1	Dysthymia	15	0.1
F39	Unspecified mood [affective] disorder	7	0
F40.0	Agoraphobia	2	0
F40.1	Social phobias	1	0
F40.2	Specific (isolated) phobias	1	0
F40.8	Other phobic anxiety disorders	1	0
F41.0	Panic disorder [episodic paroxysmal anxiety]	6	0
F41.1	Generalized anxiety disorder	54	0.2
F41.2	Mixed anxiety and depressive disorder	101	0.5
F41.8	Other specified anxiety disorders	1	0
F41.9	Anxiety disorder, unspecified	24	0.1
F42.0	Predominantly obsessional thoughts or ruminations	1	0
F42.9	Obsessive-compulsive disorder, unspecified	37	0.2
F43.0	Acute stress reaction	8	0
F43.1	Post-traumatic stress disorder	66	0.3
F43.2	Adjustment disorders	25	0.1
F45.0	Somatization disorder	1	0
F45.2	Hypochondriacal disorder	5	0
F48.9	Neurotic disorder, unspecified	1	0
F50.2	Bulimia nervosa	1	0
F50.9	Eating disorder, unspecified	2	0
F51.0	Nonorganic insomnia	1	0
F53.0	Mild mental and behavioural disorders associated with the puerperium, not elsewhere classified	1	0
F60.0	Paranoid personality disorder	3	0
F60.2	Dissocial personality disorder	4	0
F60.3	Emotionally unstable personality disorder	151	0.7
F60.6	Anxious [avoidant] personality disorder	1	0
F60.7	Dependent personality disorder	2	0
F60.8	Other specific personality disorders	1	0
F60.9	Personality disorder, unspecified	8	0
F61	Mixed and other personality disorders	2	0
F64.9	Gender identity disorder, unspecified	1	0

Table 4. Primary diagnoses: “other”.

		n	%
F70.0	Mild mental retardation: With the statement of no, or minimal, impairment of behaviour	9	0
F70.1	Mild mental retardation: Significant impairment of behaviour requiring attention or treatment	4	0
F70.9	Mild mental retardation: Without mention of impairment of behaviour	18	0.1
F71.0	Moderate mental retardation: With the statement of no, or minimal, impairment of behaviour	4	0
F71.9	Moderate mental retardation: Without mention of impairment of behaviour	10	0
F72.0	Severe mental retardation: With the statement of no, or minimal, impairment of behaviour	6	0
F72.1	Severe mental retardation: Significant impairment of behaviour requiring attention or treatment	3	0
F72.9	Severe mental retardation: Without mention of impairment of behaviour	13	0.1
F73.9	Profound mental retardation: Without mention of impairment of behaviour	1	0
F79.9	Other mental retardation: Without mention of impairment of behaviour	3	0
F84.0	Childhood autism	1	0
F84.1	Atypical autism	6	0
F84.5	Asperger's syndrome	14	0.1
F90.0	Disturbance of activity and attention	5	0
G32.8	Postviral fatigue syndrome	1	0
G93.3	Down's syndrome, unspecified	1	0
Q90.9	Down's syndrome, unspecified	3	0

Table 5. Primary diagnoses: “symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified”.

		n	%
R44.0	Auditory hallucinations	2	0
R45.8	Other symptoms and signs involving emotional state	14	0.1
R46.2	Strange and inexplicable behaviour	1	0
R46.8	Other symptoms and signs involving appearance and behaviour	1	0
Z73.3	Stress, not elsewhere classified	1	0
Total		21,701	100

Table 6. Social determinants.

		n
Z56.0	Unemployment, unspecified	2
Z56.6	Other physical and mental strain related to work	1
Z59.0	Homelessness	1
Z60.2	Living alone	3
Z60.9	Problem related to social environment, unspecified	2
Z61.4	Problems related to alleged sexual abuse of child by person within primary support group	7
Z61.5	Problems related to alleged sexual abuse of child by person outside primary support group	2
Z61.8	Other negative life events in childhood	1
Z61.9	Negative life event in childhood, unspecified	1
Z63.4	Disappearance and death of family member	6
Z63.5	Disruption of family by separation and divorce	4
Z63.7	Other stressful life events affecting family and household	3
Z63.8	Other specified problems related to primary support group	1
Z65.3	Problems related to other legal circumstances	1
Z65.8	Other specified problems related to psychosocial circumstances	5
Z72.6	Gambling and betting	2
Z73.3	Stress, not elsewhere classified	1
	Sub total	43

Table 7. Other (primarily service-related) “Z-codes”.

		n
Z72.0	Tobacco use	2
Z72.1	Alcohol use	28
Z72.2	Drug use	132
Z81.1	Family history of alcohol abuse	4
Z81.3	Family history of other psychoactive substance abuse	1
Z81.8	Family history of other mental and behavioural disorders	21
Z75.1	Person awaiting admission to adequate facility elsewhere	2
Z91.1	Personal history of noncompliance with medical treatment and regimen	76
Z91.5	Personal history of self-harm	453
	Sub total	762

Table 8. Other (primarily medical) “Z-codes”.

		n
Z82.0	Family history of epilepsy and other diseases of the nervous system	1
Z84.2	Family history of other diseases of the genitourinary system	1
Z85.0	Personal history of malignant neoplasm of digestive organs	3
Z85.1	Personal history of malignant neoplasm of trachea, bronchus and lung	1
Z85.3	Personal history of malignant neoplasm of breast	8
Z85.4	Personal history of malignant neoplasm of genital organs	4
Z85.5	Personal history of malignant neoplasm of urinary tract	1
Z85.8	Personal history of malignant neoplasms of other organs and systems	1
Z86.0	Personal history of other neoplasms	3
Z86.1	Personal history of infectious and parasitic diseases	6
Z86.3	Personal history of endocrine, nutritional and metabolic diseases	2
Z86.4	Personal history of psychoactive substance abuse	190
Z86.5	Personal history of other mental and behavioural disorders	98
Z86.6	Personal history of diseases of the nervous system and sense organs	12
Z86.7	Personal history of diseases of the circulatory system	62
Z87.0	Personal history of diseases of the respiratory system	2
Z87.1	Personal history of diseases of the digestive system	18
Z87.2	Personal history of diseases of the skin and subcutaneous tissue	1
Z87.3	Personal history of diseases of the musculoskeletal system and connective tissue	2
Z87.4	Personal history of diseases of the genitourinary system	9
Z87.5	Personal history of complications of pregnancy, childbirth and the puerperium	1
Z87.8	Personal history of other specified conditions	17
Z88.0	Personal history of allergy to penicillin	57
Z88.1	Personal history of allergy to other antibiotic agents	4
Z88.6	Personal history of allergy to analgesic agent	4
Z88.8	Personal history of allergy to other drugs, medicaments and biologic	9
Z89.4	Acquired absence of foot and ankle	1
Z89.6	Acquired absence of leg above knee	1
Z89.7	Acquired absence of both lower limbs [any level, except toes alone]	1
Z90.1	Acquired absence of breast(s)	4
Z90.2	Acquired absence of lung [part of]	1
Z90.4	Acquired absence of other parts of digestive tract	4
Z90.7	Acquired absence of genital organ(s)	1
Z91.0	Personal history of allergy, other than to drugs and biological subs	6
Z92.1	Personal history of long-term (current) use of anticoagulants	9
Z92.2	Personal history of long-term (current) use of other medicaments	2
Z93.2	Ileostomy status	5
Z93.3	Colostomy status	3
Z95.0	Presence of cardiac pacemaker	2
Z95.1	Presence of aortocoronary bypass graft	2
Z96.0	Presence of urogenital implants	1
Z96.6	Presence of orthopaedic joint implants	1
Z96.7	Presence of other bone and tendon implants	2
Z96.8	Presence of other specified functional implants	2
Z97.0	Presence of artificial eye	1
Z97.1	Presence of artificial limb (complete)(partial)	1
Z98.2	Presence of cerebrospinal fluid drainage device	1
Z98.8	Other specified postsurgical states	2
Z21	Asymptomatic human immunodeficiency virus [HIV] infection status	2
Z33	Pregnant state, incidental	3
	Sub total	574